Yenidoğan Yoğun Bakımımızda Alt Solunum Yolu Enfeksiyonu Tanısıyla Yatırılan Olguların Değerlendirilmesi

Abstract

Amaç: Alt solunum yolu enfeksiyonları (ASYE) tüm dünyada, yenidoğanların yoğun bakıma yatışının en sık sebeplerinden biridir. Bu çalışmadaki amacımız; ASYE tanısı ile yenidoğan yoğun bakım ünitesine yatırılan yenidoğanların risk faktörleri, demografik verileri ve klinik özelliklerinin değerlendirilmesidir. Materyal ve metod: Kesitsel ve retrospektif olarak yapılan çalışmamızda, hastanemizin yenidoğan yoğun bakım ünitesine Aralık 2023 ile Temmuz 2024 tarihleri arasında, ASYE tanısıyla yatırılan 23 olgu incelenmiştir. Bulgular: Çalışmaya dahil edilen 23 hastanın 11’i (%47,8) erkek, 12’si (%52,1) kızdı. Olguların 10’u (%43,4) normal spontan vajinal yol, 13’ü (%56,5) sezaryen ile doğdu. Gestasyon haftaları ortalama 37,1±0,5 hafta, ortalama doğum ağırlıkları 2864±108 gramdı. Hastaların ortalama tanı yaşı 21±1,9 gün, hastanede yatış süreleri ise 6,9±0,6 gündü. Polimeraz zincir reaksiyonu (PCR) yöntemi ile saptanan etkenler açısından; RSV 7 olgu (%30,4) ile en sık etken olurken ikinci sırada SARS-COV2 virüsü 5 olgu (%21,7) olarak karşımıza çıktı. Yatırılan olguların 13’ü (%56,5) destek tedavisi, 6’sı (%26) intravenöz ampisilin, 3’ü (%13) intravenöz ampisilin ve sefotaksim, 1’i (%4,3) ise oral azitromisin tedavisi ile izlendi. Olguları; cinsiyet, doğum haftası, doğum ağırlığı, anne yaşı, kardeş sayısı, beyaz küre, C-reaktif protein, nötrofil ve lenfosit sayısı, nötrofil/lenfosit oranı, mekanik ventilatörde kalma süresi, yattığı gün sayısı, tanı yaşı ve oksijen aldığı gün sayısı etken dikkate alınarak kıyaslandığında istatistiksel olarak anlamlı bir fark saptanmadı. Sonuç: Yenidoğan yoğun bakım ünitemize ASYE tanısı ile yatırılan olgularda en sık etken RSV saptandı. Hastalara erken dönemde bakılan PCR ile etkenin saptanması gereksiz antibiyotik ve antibiyotiğe bağlı yan etkileri azaltmak açısından önemlidir.

Keywords

• Yenidoğan
• Alt solunum yolu enfeksiyonu
• Polimeraz zincir reaksiyonu

Evaluation of Newborn Hospitalized with Lower Respiratory Tract Infection in Our Neonatal Intensive Care Unit

Abstract

Background: Lower respiratory tract infections (LRTIs) are one of the most common causes of neonatal intensive care unit admission worldwide. The aim of this study was to evaluate the risk factors, demographic data and clinical characteristics of neonates hospitalized in the neonatal intensive care unit with a diagnosis of LRTI. Materials and Methods: In this cross-sectional and retrospective study, 23 cases admitted to the neonatal intensive care unit of our hospital between December 2023 and July 2024 with the diagnosis of LRTI were analyzed. Results: Of the 23 patients included in the study, 11 (47.8%) were boys and 12 (52.1%) were girls. Ten (43.4%) were born by normal spontaneous vaginal delivery and 13 (56.5%) by cesarean section. Mean gestational age was 37.1±0.5 weeks and mean birth weight was 2864±108 grams. The mean age at diagnosis was 21±1.9 days and the mean duration of hospitalization was 6.9±0.6 days. In terms of the agents detected by polymerase chain reaction (PCR) method, RSV was the most common agent with 7 cases (30.4%) and SARS-COV2 virus was the second most common agent with 5 cases (21.7%). Of the hospitalized cases, 13 (56.5%) were followed up with supportive care, 6 (26%) with intravenous ampicillin, 3 (13%) with intravenous ampicillin and cefotaxime, and 1 (4.3%) with oral azithromycin. No statistically significant difference was found when the cases were compared according to gender, birth week, birth weight, maternal age, number of siblings, white blood cell count, C-reactive protein, neutrophil and lymphocyte count, neutrophil/lymphocyte ratio, length of stay on mechanical ventilator, number of days hospitalized, age at diagnosis and number of days on oxygen. Conclusions: RSV was the most common causative agent in patients hospitalized with LRTI in our neonatal intensive care unit. Detection of the causative agent by PCR in the early period is important to reduce unnecessary antibiotics and antibiotic-related side effects.

Keywords

• newborn
• lower respiratory tract infection
• polymerase chain reaction

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